The $400 million in Medicaid cuts facing Arkansas are not unique. Other states are struggling, too.

These really are cuts, by the way. When costs rise and you offset them by reducing services, that’s a cut, whether the gross amount spent has increased or not. When the number of people eligible increases, you may have expanded the number of people served, but to make a constrained budget cover them, something has to give.

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Because they are temporarily barred from reducing eligibility, states have been left to cut “optional benefits,” like dental and vision care, and reduce payments to doctors and other health care providers.

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